Acupuncture Combined with Auricular Acupoints Patches for Moderate to Severe Nicotine Dependence：a Randomized Controlled Study / 中医杂志

ObjectiveTo compare the efficacy and safety of acupuncture combined with auricular acupoints patches and nicotine transdermal patch in treating moderate to severe nicotine dependence. MethodsIn a rando-mized controlled trial， 64 quit smoking voluntary subjects with moderate to severe nicotine dependence were randomly divided at a ratio of 1∶1 into a treatment group and a control group， with 32 cases in each group. The treatment group was given acupuncture combined with auricular acupoints patches， twice weekly， four weeks as a course for two courses. The control group was given nicotine transdermal patch， one patch per day for 24 hours， 8 weeks. The cure rate was assessed after treatment and at follow-up （the 16th week after treatment）.The daily smoking volume， exhaled carbon monoxide （CO） value， Nicotine Dependence Scale （FTND）， Minnesota Nicotine Withdrawal Symptoms Scale （MNWS）， and Pittsburgh Sleepiness Index Inventory （PSQI） were evaluated before and after treatment and at follow-up， and adverse effects were recorded. ResultsIn terms of the cure rate， there were both six cured cases （20%） after treatment and at follow-up in the treatment group， while in the control group， seven （23.3%） and five （16.7%） patients were cured after treatment and at follow-up， respectively， with no statistically significant differences between the two groups both after treatment and at follow-up （P＞0.05）. The daily smoking volume and exhaled CO value significantly decreased after treatment and at follow-up in both groups （P＜0.05）， but were not significantly different between the groups after treatment and at follow-up （P＞0.05）. After treatment and at follow-up， FTND， MNWS， and PSQI scores were significantly reduced in both groups compared with those before treatment （P＜0.05）. There was no statistically significant difference in the FTND scale scores between the two groups after treatment and at follow-up （P＞0.05）， while the MNWS and PSQI scale scores were lower in the treatment group than in the control group （P＜0.05）. ConclusionAcupuncture combined with auricular acupoint patches for moderate to severe nicotine dependence has comparable effect with the first-line drug nicotine patch in terms of increasing the cure rate and decreasing the degree of nicotine dependence， and is superior to nicotine patch in terms of relieving withdrawal symptoms and improving sleep， with stable long-term effect.

Need for Mindfulness-based Relapse Prevention Strategies for Postpartum Smoking Relapse Prevention

The health concerns for women are varied from that of men and are of higher concern. To increase this concern, women have recorded higher smoking relapse rates than men were an alarming 60% to 90% of the women who have attempted to quit relapse within their first year. Women who quit during pregnancy are seen to have higher rates of relapse than others. Such postpartum relapse has detrimental effects on the mother as well as the newborn. Mindfulness?based interventions have seen benefits in the areas of substance abuse and relapse prevention. Although research in the area of mindfulness and its benefits on smoking cessation has been limited, literature shows positive outcomes. This brief article examines the need for mindfulness-based relapse prevention strategies for women who are undergoing postpartum smoking relapses so that they could benefit from the same.

A CROSS SECTIONAL STUDY OF NICOTINE DEPENDENCE AND ITS DETERMINANTS IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AT INSTITUTE OF RESPIRATORY DISEASES, SAWAI MAN SINGH MEDICAL COLLEGE, JAIPUR, RAJASTHAN.

Background: Smoking cessation is the most powerful intervention to modify progression of chronic obstructive pulmonary disease (COPD), and nicotine dependence is one of the most important determinants of success or failure in smoking cessation. Thus, nicotine dependence status and factors associated with moderate to high nicotine Dependence in patients with COPD needs to be evaluated. Method: A hospital based cross-sectional observational study performed on 50 patients with COPD attending the outpatient department at smoking cessation clinic, Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan during 2019-2020. Result: Multiple logistic regression analysis revealed that low education status, age 60 yrs., and mild to moderate airflow obstruction were related to moderate to high nicotine dependence. Conclusion: Nicotine dependence does not correlate with smoking amount, but with education level, age, and severity of airflow obstruction. Physicians should provide different strategies of smoking cessation intervention for current smokers with COPD according to their education levels, age, and severity of airflow obstruction.

Study of Association of Nicotine Dependence and Depression among Medical Outpatients

Background: Nicotine dependence and depression have been associated in many studies. The current study aims to determine the association of nicotine dependence and depression, the association of severity of nicotine dependence with depression and the severity of depression in nicotine dependent patients suffering from depression. Methodology: It was an observational, cross sectional, and comparative study. 150 consecutive patients attending medical OPD diagnosed as having nicotine dependence by Diagnostic Statistical Manual (DSM)- 5 were screened by Fagerstrom test, Modified Fagerstrom scale and diagnostic criteria of Major Depressive Disorder using DSM-5. Hamilton Depression (HAM-D) rating scale was applied to patients suffering from depression to know the severity. Statistical analysis was done using z test, Chi square test, Fischer’s exact test and Odds’ ratio. Results: Patients with nicotine dependence were found to have statistically significant higher rate of depression than persons without nicotine dependence. (17.8 % vs 8.6%). It was found more in married patients (52%) and in patients from lower socio-economic class (75%). 72.7% of patients used smokeless forms. Conclusion: Though highly prevalent, tobacco use disorder is often ignored due to absence of behavioral symptoms. Not only there is increase prevalence of depression in nicotine dependent patients, having depression can lead to increased chances of nicotine dependence. Hence addressing nicotine use is essential for better prognosis of both disorders

Assessment of Nicotine Dependence Using Fagerstrom Test among Patients with Leukoplakia and Oral Submucous Fibrosis

Tobacco consumption has an influence on the oral mucosa and causes oral malignancy in the due time. On assessing nicotine dependence, appropriate counselling can be given to prevent further progression of the habit. Aim of this study was to assess the nicotine dependence levels among patients with potentially malignant disorders such as leukoplakia and Oral Submucous Fibrosis (OSMF) using fagerstrom test. This study included 140 patients from October 2019 to January 2020 in a dental hospital. Variables such as age, gender, tobacco form and lesion were assessed. Descriptive and chi square statistics were performed. Out of 140 patients, higher prevalence with tobacco usage were among 41-50 years (40%), 94.29% were males and 5.71% were females, 16.43% had low dependency, 52.86% had medium dependency and 30.71% had high dependency. Association between   age; nicotine dependency in patients with and without lesion p=0.000(p<0.05), statistically significant. Association between gender and patients with and without lesions p=0.151(p>0.05), statistically not significant. Within the limitations of the present study, males had higher prevalence of tobacco use among 41-50 years. Patients with potentially malignant disorders and smokers without lesion had medium dependence while smokeless tobacco users without lesion had a high dependence

Levels of nicotine dependence in the elderly and cognitive impairment / Niveles de dependencia de nicotina en ancianos y deterioro cognitivo

Abstract Introduction Health problems in elderly individuals are diverse. The use of cigarettes, a potentially addictive substance, has been increasing in the elderly population age group, affecting the cognitive and elderly domains, and becoming an important global public health problem. Objective This study aimed to investigate the relationship between tobacco consumption by the elderly, as well as different levels of nicotine dependence and cognitive domains of executive functions. Method It is a case-control study composed by 58 individuals aged ≥ 60 years, with 29 participants in the clinical group and 29 in the control group. The case-control sample was paired in subgroups by sex, socioeconomic status, schooling, and sample isonomy with the clinical group. We used the Shapiro-Wilk normality test, the Mann-Whitney test, the student T-test, and the Cohen d-estimator. Results The control group performed better compared to the clinical group with the median grade in the inhibitory control of the executive domain with Cohen's d 1.00 in the five-digit test and Cohen's 1.5 in the Stroop test. The control group compared with the high-grade clinical group presented better performance with Cohen's working memory of 1.56 d, Cohen's inhibition of 1.06 d in the five-digit test, and Cohen's of 1.17 d in the Stroop test. Discussion and conclusion The detection of the level of nicotine dependence is associated with the degree of cognitive impairment in the specific executive domain, which provides a possibility of differential diagnosis, both in the clinical and population contexts, directed at the rehabilitation of executive domains most affected by smoking in the elderly.

Resumen Introducción Los problemas de salud en las personas mayores son diversos. El consumo de tabaco, una sustancia potencialmente adictiva, ha aumentado en el grupo de edad de la población de ancianos, afectando los dominios cognitivos y de ancianos, convirtiéndose en un importante problema de salud pública mundial. Objetivo Este estudio tuvo como objetivo investigar la relación entre el consumo de tabaco en los ancianos, los diferentes niveles de dependencia de la nicotina y los dominios cognitivos de las funciones ejecutivas. Método Es un estudio de casos y controles, compuesto por 58 individuos de ≥ 60 años, con 29 participantes en el grupo clínico y 29 en el control. La muestra de casos y controles se emparejó en subgrupos por sexo, nivel socioeconómico, escolaridad e isonomía de la muestra con el grupo clínico. Se utilizaron la prueba de normalidad Shapiro-Wilk, la prueba de Mann-Whitney, la prueba Student T y el estimador d de Cohen. Resultados El grupo de control se desempeñó mejor en comparación con el grupo clínico con el grado medio en el control inhibitorio del dominio ejecutivo con Cohen's d 1.00 en la prueba de cinco dígitos y Cohen's 1.5 en la prueba de Stroop. En comparación con el grupo clínico de alto grado, el grupo de control presentó un mejor rendimiento con la memoria de trabajo de Cohen de 1.56 d, la inhibición de Cohen de 1.06 d en la prueba de cinco dígitos y la de Cohen de 1.17 d en la prueba de Stroop. Discusión y conclusión La detección del nivel de dependencia de la nicotina se asocia con el grado de deterioro cognitivo en el dominio ejecutivo específico, lo que brinda la posibilidad de un diagnóstico diferencial, tanto en el contexto clínico como en el de la población, dirigido a la rehabilitación de los dominios ejecutivos más afectados por el tabaquismo en los ancianos.

Changes in smoking behavior among victims after the great East Japan earthquake and tsunami

BACKGROUND@#In areas affected by the tsunami of the great East Japan Earthquake, smoking behavior may have deteriorated due to high stress and drastic changes in living environment. Surveys were conducted to reveal changes in smoking behaviors among victims.@*METHODS@#A population-based random-sample home-visit interview survey of victims in Iwate and Miyagi Prefectures affected by the tsunami disaster was conducted in 2012 (n = 1978), while a population-based nationwide survey was conducted in 2013 (n = 1082). A panel survey in 2014 was conducted with respondents of the 2012 survey (n = 930). Multiple logistic regression analysis was performed to reveal factors related to smoking status after the disaster.@*RESULTS@#There was high smoking prevalence of both sexes in the tsunami disaster area (current smoking rate in coastal area, 50.0% for male, 21.4% for female; inland area, 34.7% for male, 7.6% for female). Low prevalence of male quitters was observed (quitter rate in coastal area, 20.8% for male, 8.0% for female; inland area, 23.4% for male, 5.5% for female). The prevalence of nicotine-dependent people assessed by FTND (Fagerström Test for Nicotine Dependence) in the coastal area was also higher than in the inland area or other areas of Japan. Smoking behavior among victims worsened after the disaster and did not improve 3 years from the disaster. Post-disaster factors related to smoking were living in coastal area, complete destruction of house, and living in temporary housing.@*CONCLUSIONS@#Smoking prevalence and the level of nicotine dependence of tsunami victims were still high even 3 years after the disaster. It is important to emphasize measures for smoking control in the disaster areas for an extended time period.

A Study of Prevalence and Clinical Correlates of Nicotine Dependence among Patients with Bipolar Disorder

Introduction: In India, the studies specifically examining the relationship between smoking and bipolar disorder are scarce. Even in the studies reported, only smoking tobacco has been included. In India where the predominant form of tobacco abuse by women being smokeless tobacco, this approach would exclude most female sample. So, we propose to examine the pattern of both smoking and smokeless tobacco among the bipolar patients and to correlate the same to the socio-demographic data and comorbid other substance abuse. Material and methods: We examined the prevalence of smoking in of 92 patients who met the Clinical Diagnosis and Description Guidelines, Tenth Edition criteria for bipolar I disorder and evaluated the relationship between smoking and demographic and clinical data and the difference in smoking and smokeless tobacco use. Results: Fifty-five of the bipolar patients (59.7%) smoked, a rate that is higher than among the general population in India (48%). The form of tobacco use was significantly correlated to sex. Significant relationships were revealed between nicotine use and family history of substance abuse and between smoking and history of alcohol use. The severity of dependence of smoking tobacco could correlate to the severity of dependence of Alcohol but not smokeless tobacco. The severity of current episode of mania predicts the severity of smokeless tobacco use. Conclusion: Bipolar patients smoke more than the general population. Bipolar patients that are moderate or heavy smokers are more likely than non-smokers to consume alcohol. However, no association was found between clinical variables of bipolar patients and smoking.

Intention To Quit Tobacco Smoking And Its Predictors Among Adult Male Smokers At Singur, West Bengal

Background: Tobacco is the single most preventable cause of death and disability. Quitting tobacco use at any age will help in improving the quality of health. Objective: To find out the intention to quit tobacco smoking and its predictors among adult male smokers. Methodology: A cross–sectional clinic based study was conducted for 2 months (July–august 2017) among 123 adult male current smokers. Nicotine dependence was assessed using Fagerstrom test for nicotine dependence (FTND) questionnaire and intention to quit tobacco smoking and its various predictors were assessed using structured schedule. Logistic regression was done to establish association. Results: Intention to quit tobacco smoking significantly associated with higher educational status (AOR=3.04. CI=1.32–6.98),low nicotine dependence(AOR=3.85, CI=1.52–9.73),less duration of tobacco smoking( AOR=2.33, CI=1.02–5.31),previous H/O quit attempts (AOR=2.73, CI=1.17–6.32) Conclusion: The low rate of quitting intention among adult smokers underscore the need for comprehensive policy initiatives that would encourage smokers to think about quitting. Keywords: Tobacco smoking, Nicotine dependence, Intention to quit smoking

Effect of monoamine oxidase B A644G variant on nicotine dependence and/or schizophrenia risk

Abstract Objectives Schizophrenia (Sch) is a severe and chronic mental illness. Smoking prevalence is higher in patients with Sch than general population. We aimed to investigate the effects of MAOB gene A644G variant on nicotine dependence (ND) and Sch+ND risk in Turkish population and to evaluate by bioinformatic analysis. Methods Present study included 161 individuals with ND, 223 patients with Sch+ND, and 96 non-smoker controls. MAOB A644G variant was analyzed using PCR-RFLP method. As the MAOB gene is located on the X chromosome, each gender was analysed separately. Results The total distributions of AA, AG and GG genotypes of MAOB gene A644G were 44.7%, 22.4% and 32.9% in the ND group, 45.3%, 25.1% and 29.6% in the Sch+ND group and, 44.8, 22.9% and 32.3% in non-smoker controls. No significant differences were observed between groups for the MAOB A644G genotype and allele frequencies when female group compared to male group (p > 0.05). Examination of disease associations of SNPs from each miRNA gene region in GWAS databases yielded results for aging, bipolar disorder, autoimmune, and neurological diseases. Discussion Our results indicate that the MAOB gene A644G variant is not associated with ND and/or Sch susceptibility in the Turkish population.

A study on the real world effect of the combination of bupropion hydrochloride sustained release tablets with behavior intervention on smoking cessation / 中国实用内科杂志

OBJECTIVE: To discuss the real world effect of bupropion hydrochloride sustained-release tablets and psychological intervention as well as WeChat publicity and follow-up on smoking cessation. METHODS: Totally 283 subjects were divided into two groups according to their own wishes: 84 people chose WeChant and psycholigical intervention, and were defined as control group; 199 people chose bupropion hydrochloride and WeChant and psycholigical intervention, and were defined as treatment group. The one-month smoking cessation rate and weight changes of the two groups in 3 months was compared, and the factors affecting the smoking cessation rate were analyzed. RESULTS: The success rate was 57.8% in treatment group, and the success rate of the control group was 10.7%. There was a statistically significant difference between the two groups. The average weight gain was 2.6 kg in the treatment group, and in the control group it was 3.5 kg, with no statistically significant difference. The presence of depression, intervention pattern, smoking-related disease, the number of cigarettes smoked per day, and the need to quit smoking for family members and the readiness to quit were statistically siginificant factors. The faliure rate of smoking cessation in depressed smokers was 7.772 times that of non-derpessed smokers, and it was4.492 times that of people with smoking related deseases. The failure rate of smoking cessation in people smoking more than20 cigarettes a day was 4.090 times that of pepople smoking less than 20. The failure rate in smokers without family requests of quiting smoking was 0.463 times that of those with requests; the failure rate in smokers without readiness was0.274 times that of those with proper readiness. The failure rate in control group was 14.292 times that of the treatment group. CONCLUSION: Bupropion hydrochloride sustained-release tablets + psychological intervention + WeChat platform promotion can significally increase the rate of sucessful smoking cessation. Factors affecting the success rate of smoking cessation are depression, intervention methods, smoking-related deseases, the number of cigarettes smoked, family requirements and smoking cessation preparations.

Effect of the different smoking cessation regimens with acupuncture on smoking withdrawal and their influence factors: a multi-center randomized controlled trial / 中国针灸

OBJECTIVE@#To evaluate the clinical effect of acupuncture on smoking cessation and withdrawal symptoms and to explore the influence factors of acupuncture on smoking cessation.@*METHODS@#A total of 500 subjects with tobacco dependence were randomized into an acupuncture group, an auricular therapy group, an acupuncture plus auricular therapy group, a TENS group and a nicotine replacement therapy group (NRT group), 100 cases in each one. In the acupuncture group, acupuncture was applied at Baihui (GV 20), Lieque (LU 7), Hegu (LI 4) and Zusanli (ST 36). The treatment was given 5 times a week, once a day in the first 2 weeks. The treatment was given once every 2 days in the week 3 and 4, 3 times a week, and twice a week, once every 3 days in the week 5 to 8. In the auricular therapy group, the ear point pressure therapy was used at shenmen (TF), neifenmi (CO), pizhixia (AT) and jiaogan (AH), 3 times a week. In the acupuncture plus auricular therapy group, acupuncture and auricular therapy were adopted with the same points and manipulation as the previous two groups. Acupuncture was given 3 times a week and the auricular therapy was given twice a week. In the TENS group, SDZ-Ⅱ B type electric acupuncture apparatus was used to stimulate Lieque (LU 7) and Zusanli (ST 36), once a day. In the NRT group, the nicotine patch was used on the chest, back and the upper arms of the subjects, once a day. The duration of treatment was 8 weeks as one course in every group. Afterwards, the 16-week follow-up was conducted. The time-point withdrawal rate was evaluated by the level of urine cotinine in 8 weeks of treatment and in the follow-up in the subjects of 5 groups. The persistent withdrawal rate was evaluated by the self-report of the subjects in 8 weeks of treatment as well as in the follow-up in the 5 groups. The withdrawal effect, the score of the fagerstrom test for nicotine dependence (FTND) and the score of the heaviness of smoking index (HSI) were compared among the groups. Twenty indexes were selected as the potential influence factors, the 72 h withdrawal rate based on the level of urine cotinine in 8 weeks of treatment and in the follow-up was taken as the dependent variable. Using the two categories of Logistic regression analysis, the influence factors of therapeutic effect of acupuncture were screened for smoking cessation.@*RESULTS@#After 8 weeks of treatment, the time-point withdrawal rate in the subjects among the groups was NRT group > acupuncture plus auricular therapy group > auricular therapy group > acupuncture group > TENS group. In the follow-up, the time-point withdrawal rate was acupuncture plus auricular therapy group > NRT group > acupuncture group > TENS group > auricular therapy group, but without statistical significance in comparison (>0.05). After 8 weeks of treatment, the persistent withdrawal rate in the subjects among the groups was auricular therapy group > TENS group > acupuncture group > acupuncture plus auricular therapy group > NRT group. In the follow-up visit, the persistent withdrawal rate was auricular therapy group > TENS group > acupuncture plus auricular therapy group > acupuncture group > NRT group. The result in the auricular therapy group was better than all of the other 4 groups (0.05). The regression analysis showed that the factors, i.e. nationality, educational background, drinking frequency, pre-treatment FTND score, pre-treatment HSI score and smoking cessation for physical reason in family, were correlated significantly with the withdrawal result after 8-week treatment (<0.05). The factors, i.e. education background, smoking age, pre-treatment FTND score and different therapeutic methods, were correlated significantly with the withdrawal result in the follow-up (<0.05).@*CONCLUSION@#Acupuncture combined with auricular therapy effectively reduce nicotine dependence and smoking intensity and relieve withdrawal symptoms. There are many factors that affect the withdrawal effect in smoking cessation. Hence, the influence factors in smoking cessation with acupuncture should be clearly determined so as to develop the individual regimen for smoking cessation and improve the clinical therapeutic effect of acupuncture on smoking cessation.

Comparative study of acupoint catgut embedding and bupropion hydrochloride sustained-release tablets for tobacco dependence / 中国针灸

OBJECTIVE@#To compare the clinical efficacy of acupoint catgut embedding and bupropion hydrochloride sustained-release tablets in the treatment of tobacco dependence.@*METHODS@#A total of 100 patients with tobacco dependence who met the inclusion criteria were randomly divided into an acupoint catgut embedding group and a drug group, 50 cases in each group. In the acupoint catgut embedding group, acupoint catgut embedding was applied at Xinshu (BL 15), Shenmen (HT 7), Tianmei (Extra), Taichong (LR 3), the treatment was given once every 2 weeks for 4 times; The bupropion hydrochloride sustained-release tablets was orally administered in the drug group for 7 weeks, 150 mg each time, once a day for the first 3 days, twice daily from day 4 to day 7, and once a day after day 8. The Fagerström test for nicotine dependence (FTND) score before and after treatment, the 4th and 8th week smoking cessation rate, the continuous smoking cessation rate and efficacy, compliance rate and adverse reaction rate were compared in the two groups.@*RESULTS@#A total of 100 patients were enrolled, and 97 patients completed the study (loss rate was 3%), including 49 cases in the acupoint catgut embedding group and 48 cases in the drug group. The FTND scores in the two groups were lower than those before treatment (both 0.05). At the 4th and the 8th week, the smoking cessation rate in the acupoint catgut embedding group was 40.8% (20/49) and 79.6% (39/49) respectively, the smoking cessation rate in the drug group was 41.7% (20/48) and 83.3% (40/48) respectively, the two groups were equally effective (both >0.05). The continuous smoking cessation rate in the acupoint embedding group was 40.8% (20/49), which was equivalent to 41.7% (20/48) in the drug group (>0.05). The rate of complete compliance in the acupoint embedding group was 61.2% (30/49), which was significantly better than 37.5% (18/48) in the drug group (<0.05). The adverse reaction rate in the acupoint catgut embedding group was 12.2% (6/49), which was significantly lower than 29.2% (16/48) in the drug group (<0.05).@*CONCLUSION@#Acupoint catgut embedding can effectively improve the symptoms of tobacco dependence after smoking cessation. Its curative effect is close to that of bupropion hydrochloride sustained-release tablets, and it has good clinical compliance and less adverse reactions.

Association between Nicotine Dependence and Depressive Mood among Patients of Smoking Cessation Clinic

BACKGROUND: This study evaluated the association between nicotine dependence and depressive mood in patients who visited a secondary hospital for smoking cessation treatment.METHODS: From March 2016 to February 2017, a total of 48 patients who visited the smoking cessation clinic of a secondary hospital in Seoul were surveyed through questionnaires. Nicotine dependence was assessed by the Fagerström Test for Nicotine Dependence. The Beck Depression Inventory (BDI) was used to assess depressive mood.RESULTS: The mean BDI score was positively associated with nicotine dependence (P=0.01). In multivariable logistic regression analysis, increasing BDI was associated with higher odds (1.21, 95% confidence interval; 1.02–1.44) of high nicotine dependence after adjusting for all confounding variables.CONCLUSION: Depressive mood was positively associated with nicotine dependence among patients who visited a smoking cessation clinic. Consideration of depressive mood in smoking cessation treatment may be helpful for smoking cessation among patients with a willingness to quit smoking.

Effect of Nicotine Dependence on Cognition and Quality of Life in Patients Suffering from Schizophrenia

Introduction: The purpose of the present study was to examine the impact of nicotine dependence oncognition and quality of life in patients suffering from schizophrenia. The research was carried out to see ifthere is any significant difference between the cognition and quality of life among patients withschizophrenia having nicotine dependence in comparison to the no nicotine consumption group.Methodology: This study was carried out using the survey method. There were total 69 participants, allwere males and the age ranged from 20 to 50 years. The participants were the outpatients visiting thegovernment hospitals in Mumbai for their follow-ups to the psychiatrists. The data was collected from theparticipants after their consent was received. The screening for severity was done and only patients ratedwith moderate disturbances on the Positive and Negative Syndrome Scale (PANSS) were considered forfurther administration of tests. The two scales Montreal Cognitive Assessment Test (MoCA) andWHOQOL-Bref (Hindi) were used for measuring cognition and quality of life respectively. The obtainedscores were analyzed using two simple independent samples t-test.Results: The results showed significant difference between the scores of cognition and quality of life amongstthe two groups. The study was found to be in line with the previous researches. The results indicated thatcognition was significantly higher in the nicotine dependent group whereas the psychological domain ofquality of life was significantly higher for the no nicotine consumption group.Conclusion: The findings indicate the group of patients with schizophrenia having nicotine dependence wasfound to have significantly higher cognition but lower perceived quality of life in psychological domain,whereas the other group of patients who did not consume nicotine showed significantly higher perceivedquality of life but lower cognitive functioning. Overall the obtained statistical analysis revealed significantdifference between the cognition and quality of life amongst nicotine dependent group and no nicotineconsumption group.

XRCC4 rs6869366 polymorphism is associated with susceptibility to both nicotine dependence and/or schizophrenia

Abstract Background: Oxidative stress induced DNA damage has been assumed to contribute to the etiopathogenesis of schizophrenia (Sch). Smoking prevalence was more common in patients with Sch. The X-ray repair cross-complementation group 4 (XRCC4) gene plays an important role in the repair of DNA double-strand breaks. Objective: The purpose of this study was to investigate whether XRCC4 rs6869366 polymorphism has a relationship both in nicotine dependence (ND) and Sch+ND risk. Methods: One hundred and four patients with Sch+ND, 133 subjects with ND only and 70 healthy controls were enrolled in the study. XRCC4 rs6869366 polymorphism was analyzed using PCR-RFLP assay. Results: The frequency of XRCC4 rs6869366 GG genotype was more common in the ND and Sch+ND group than controls (p = 0.001 and p = 0.001, respectively). XRCC4 rs6869366 TT genotype was lower in both ND and Sch+ND group compared to controls (p = 0.001 and p = 0.001, respectively). Also, XRCC4 rs6869366 G allele was higher in Sch+ND group than controls (p = 0.001) while XRCC4 rs6869366 T allele was lower in ND group than healthy controls (p=0.001). XRCC4 rs6869366 GT genotype was lower in ND group than control group (p = 0.003). Discussion: These results suggested that the XRCC4 rs6869366 polymorphism G related genotype/allele was associated with susceptibility to both ND and Sch+ND in a Turkish population.

A study of habits of tobacco use among medical students and influence of various factors including medical education

Background: Tobacco use is a major preventable cause of morbidity and mortality. Tobacco usage among medical professionals should be reduced. It is important that they are aware regarding effects/ill effects of tobacco use, anti tobacco strategies, tobacco cessation technique to reduce tobacco usage among population. Authors undertook this study to understand tobacco use among medical students.Methods: Authors conducted cross sectional, descriptive study by collecting anonymous data of 414 undergraduate medical students of medical college, Jamnagar in predesigned forms. Data were analysed using MS-excel and graphpad prism. Authors used Fagerstrom test for nicotine dependence to assess nicotine dependence.Results: Tobacco users were 19.57%, among them 83.95% were smokers. Prevalence was higher in male (34.35% in male and 1.09% in female subgroup) and students with positive family history (36.81% in positive and 6.03% in negative family history subgroup). Current users were 7.73%. They were 8.20% in hosteller and 2.78% day scholar subgroups. Authors didn抰 find statistical significant association of medical education with habit. Leading causes of starting tobacco use were curiosity/recreational purpose (35.8%), peer group pressure (32.10%) and stress (25.93%). Most of current user had low nicotine dependence (73.33%).Conclusions: Tobacco use among medical students is a significant problem. Important factors affecting it are gender, family history, current living status, stress, peer group pressure, media influences. Authors recommend that special awareness programme and specific training regarding tobacco cessation should be given to medical students.

A study of the outcome of Nicotine use disorder treatment devised as per an evidence-based treatment protocol

Introduction: Tobacco is the most common form of nicotine. It is smoked most commonly in cigarettes,then, in descending order, cigars, snuff, chewing tobacco, and in pipes. Effective treatments have now beenidentified and should be used with every current and former smoker. Guidelines that are available mightnot be specific and tailor made for patient population we come across. Hence, we reviewed and criticallyappraised available guidelines, systemic reviews, meta-analysis, review articles etc and we designed ourevidence-based treatment protocols accordingly and this study will test the treatment effectiveness innicotine use disorder.Material & Methods: It was a prospective observational study. Individuals aged above 18 years withnicotine use disorder were enrolled into the study. The participants were assessed using structuredPerforma including demographic data, quit attempts and severity of Nicotine dependence using theFagerström Nicotine Dependence Scale. Group A includes participants who were given Bupropion andGroup B were given varenicline. Follow up was done at 1 and 3 month and patients assessed for relapse.Results: Out of 90 participants 40 patients dropped out and 50 patients who completed the study, at 1month of follow up there was no significant difference in relapse between two groups but at 3 monthsfollow up compared to Group B (Varenicline), in group A (Bupropion) number of relapse is significantlyhigher (p value = 0.044).Conclusion: At the end of the 3 months, significant difference was found between the medications interms of the success of smoking cessation. Patients taking Bupropion had significantly higher relapse rateas compare to varenicline.

Association of Time to First Morning Cigarette and Chronic Obstructive Pulmonary Disease Measured by Spirometry in Current Smokers / 가정의학회지

BACKGROUND: Time to first cigarette after waking is an indicator of nicotine dependence. We aimed to identify the association between time to first cigarette and spirometry-proven obstructive respiratory impairment, especially chronic obstructive pulmonary disease, in current smokers. METHODS: We included 392 subjects who visited the comprehensive medical examination center of Hallym University Sacred Heart Hospital between July 2014 and September 2015. Subjects with lung disease or anemia were excluded. Obstructive pulmonary impairment was defined as 30 minutes) groups based on the time to first cigarette. Logistic regression and linear regression analyses were used for data analysis. RESULTS: Ninety-eight subjects (25%) were classified into the early group. After adjusting for smoking behaviors (cigarettes per day and smoking duration), socioeconomic status (education and income), age, and physical activity, an early time to first cigarette was found to be associated with an increased risk of obstructive pulmonary impairment measured using spirometry (adjusted odds ratio, 2.84; 95% confidence interval, 1.22–6.61). CONCLUSION: Compared to current smokers with a late time to first cigarette, those with an early time to first cigarette had a higher risk of obstructive pulmonary impairment, especially chronic obstructive pulmonary disease. Classifying smoking-related behaviors, especially time to first cigarette, may help target clinical screening for chronic obstructive pulmonary disease.

Névoas, vapores e outras volatilidades ilusórias dos cigarros eletrônicos / Nieblas, vapores y otras volatilidades ilusorias de los cigarrillos electrónicos / Mists, vapors and other illusory volatilities of electronic cigarettes

Resumo: Neste artigo, analisa-se o discurso de fornecedores de cigarros eletrônicos para convencer potenciais usuários (fumantes, ex-fumantes ou nunca fumantes de cigarros) a adquirir e usar o novo produto. É um estudo qualitativo, descritivo e exploratório acerca do discurso de vendedores em oito sites de venda on-line que, entre 2011 e 2013, tiveram maior frequência de buscas na Internet. Os sites foram identificados pela ferramenta Google Trends, com base no número de acessos e frequência de buscas ao tema cigarro eletrônico. Tendo como referencial metodológico a hermenêutica-dialética, a categorização do material empírico sob o esquema "compreensão/interpretação" apontou quatro abrangentes sentidos: apropriação do discurso antitabagista; comparação entre cigarros convencional e eletrônico; apelo à crença na fidedignidade da ciência; e projeção da imagem do cigarro eletrônico. A análise desses sentidos configurou os elementos argumentativos do discurso de posicionamento de marketing utilizado por fabricantes e fornecedores de cigarros eletrônicos.

Resumen: En este artículo, se analiza el discurso de provedores de cigarrillos electrónicos para convencer a potenciales usuarios (fumadores, ex-fumadores o no fumadores) a adquirir y usar el nuevo producto. Es un estudio cualitativo, descriptivo y exploratorio acerca del discurso de vendedores en ocho sitios de venta on-line que, entre 2011 y 2013, tuvieron una mayor frecuencia de búsquedas en Internet. Los sitios fueron identificados por la herramienta Google Trends, en base al número de accesos y frecuencia de búsquedas sobre el asunto cigarrillo electrónico. Teniendo como referencia metodológica la hermenéutica-dialéctica, la categorización del material empírico bajo el esquema "comprensión/interpretación" apuntó a cuatro sentidos más amplios: apropiación del discurso antitabaquista; comparación entre cigarrillos convencionales y electrónicos; apelo a la creencia en las cualidades fidedignas de la ciencia; y proyección de la imagen del cigarrillo electrónico. El análisis de esos sentidos configuró los elementos argumentativos del discurso de posicionamiento de marketing, utilizado por fabricantes y proveedores de cigarrillos electrónicos.

Abstract: In this article, we analyze the discourse of electronic cigarette suppliers directed at convincing potential users (smokers, former smokers or never smokers) to acquire and use the new product. This is a qualitative, descriptive and exploratory study on sellers' discourse found in eight on-line sales websites which, between 2011 and 2013, had the highest search frequencies. The websites were identified through Google Trends based on the number of accesses and search frequencies related to electronic cigarettes. Our methodological reference was dialectical-hermeneutics. We categorized the empirical material within the "understanding/interpretation" scheme within four broad meanings: appropriation of the anti-smoking discourse; comparison between conventional and electronic cigarettes; appeal to the trustworthiness of science and projection of e-cigarettes' image. The analysis of these meanings configured the argumentative elements of the marketing discourse used by electronic cigarette makers and suppliers.